AB0843 OSTEOPOROSIS IN PATIENTS WITH SPONDYLOARTHRITIS: DO WE NEED TO DO MORE?
Authors: Z. Özsoy, K. Moral, F. Yeşil, E. Bilgin, E. C. Bolek, G. K. Yardimci, B. Farisogullari, E. Duran, G. Ayan, G. Sandal Uzun, M. Ekici, E. Unaldi, L. Kiliç, A. Akdoğan, O. Karadag, Ş. A. Bilgen, S. Kiraz, A. İ. Ertenli, U. Kalyoncu
Journal: Annals of the Rheumatic Diseases (2022)

Background Data regarding the prevalence and especially incidence of osteoporosis in Spondylarthritis (SPA) is scarce and very divergent among studies from different patient populations (1). Objectives In this study, we aimed to compare demographic, disease and laboratory characteristics of SpA patients regarding their bone mineral densitometry (BMD) categories and find out incidence of osteoporosis in the follow-up BMD of patients who were not found to have osteoporosis at baseline. Methods Between 2010-2021, patients with a SPA diagnosis in the HUR-BIO database were searched. HUR-BIO (Hacettepe University Rheumatology Biologic Registry) is a single center biological disease modifying anti-rheumatic drug (DMARD) registry since 2010. Patients with BMD measurement were included in the study. Follow-up BMD scores were also documented. The patients were divided into 3 groups as normal, osteopenia and osteoporosis in accordance with the WHO criteria (2). Demographic characteristics, comorbidities, laboratory data and drugs in each group were documented. Results 3245 patients were reviewed. BMD was measured at least once in 118 patients out of 3245 (3.6%) patients. When the groups classified, 34 patients (28.8%) were included in the normal, 49 (41.5%) osteopenia and 35 (29.7%) osteoporosis groups. Patients with normal BMD was younger than both groups. Diabetes and hypertension were more prevalent in patients with osteopenia. The BMI was significantly lower in the osteoporosis group. 25 patients with normal and osteopenia in baseline BMD measurement had at least 1 follow-up BMD measurement. During the total follow-up of 91 patient-years, 3 patients had osteoporosis, revealing a the incidence of 3.3% in 100 patient-years. Conclusion In our study, the incidence of OP development in SPA patients was found to be 3.3%. Frequency of osteoporosis was 29.7% among SpA patients with BMD measurement (118/3245; 3.6%), however; only 40% of them had appropriate treatment. Osteoporosis seems as an overlooked and undertreated comorbidity of SpA. Table 1. Comparison of spondyloarthritis patients according to BMD scores (normal, osteopenia and osteoporosis) according to baseline BMD assessment NORMAL Number, (% ) OSTEOPENIA Number, (% ) OSTEOPOROSIS Number, (% ) P VALUE Number of Patients 34 (28.8) 49 (41.5) 35(29.7) Age 47,5 (27-70) 63 (45-79) 58 (20-75) 0.00* Gender (Female) 24 (70.6) 34 (69.4) 23 (65.7) Diabetes Mellitus 3 (8.8) 14 (29.2) 1 (2.9) 0.00* Hypertension 11 (32.4) 28 (58.3) 5 (14.3) 0.00* Chronic Renal Failure 2 (6.9) 1 (2.7) 1 (5.3) 0.81 Chronic Ostructive Pulmonary Disease 4 (13.8) 4 (10.8) 1 (5.3) 0.30 Coronary Artery Disease 0 (0) 5 (12.5) 3 (15) 0.27 Malignancy 1 (3.6) 1 (2.9) 1 (4.2) 1.0 Smoking 21 (61.8) 23 (47.9) 21 (63.6) 0.37 9 (26.5) 13 (27.1) 5 (15.2) 4 (11.8) 12 (25) 7 (21.2) Calcium mg/dl 9.4 (8.2-10.2) 9.5 (8.7-10.4) 9.7 (8.1-10.4) 0.49 Phosphorus mg/dl 3.5 (3-4.4) 3.4 (2.6-5) 3.8 (2.9-4.9) 0.25 Vitamin D ng/ml 16 (7.4-64.4) 21.2 (5-69.6) 15.8 (5.8-49.1) 0.66 ALP IU/ml 89.5 (54-137) 89.5(53-169) 80 (50-239) 0.43 Albumin g/dl 4.2 (1.7-4.7) 4.2 (3.3-8.4) 4.2 (2-4.8) 0.43 TSH mU/ml 1.5 (0.8-4.1) 2.3 (0.1-9.7) 2 (0.7-3.3) 0.71 Body Mass Index (BMI) kg/m2 29 (17-41.2) 28.3 (20-44.6) 25.1(15.8-43.2) 0,06* Steroids 4 (11.8) 8 (16.3) 2 (5.7) 0.33 Anti-TNF 25 (73.5) 35 (71.4) 26 (74.3) 0,95 D Vitamin 7 (20.6) 14 (28.6) 10 (28.6) 0.67 Calcium 4 (11.8) 5 (10.2) 6 (17.1) 0.63 Bisphosphonate 0 (0) 4 (8.2) 14 (40) 0,00* Data was represented as median (minimum-maximum) or n(%) References [1]Hu LY, Chen PM, Shen CC, et all. Should clinicians pay more attention to the potential underdiagnosis of osteoporosis in patients with ankylosing spondylitis? A national population-based study in Taiwan. PoleS one 2019:6;14 [2]Kanis JA on behalf of the World Health Organization Scientific Group (2007) Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK. 2007: Printed by the University of Sheffield. Disclosure of Interests None declared